Download Situation analysis - UNDP in Tajikistan

Situation analysis
T
ajikistan is at the earliest
stages of an HIV/AIDS epidemic.
As of 1 January 2007, 710 cases of
HIV infection have been official reported in the country. Nevertheless,
there is cause for serious concern.
UNAIDS experts estimate that (taking into account the factors conducive to the spread of HIV infection
an increasing number of injecting
drug users, sex workers, unemployment, poverty and migration), the
real number of HIV-infected people
in the country is 10000 by end 2005.
Despite gaps in data, available evidence indicates that HIV is spreading
rapidly. For instance, 393 new HIV
positive cases were registered during
2005-2006 only. It is driven largely
by the dramatic increase of intravenous drug users (IDUs) in Central
Asia, which is a nexus for the transit
of heroin. IDUs account for 70 percent of new HIV infections. More
than two third of the HIV cases are
less than 29 years old.
In 2005, Tajikistan conducted the
first sentinel surveillance in two cities (Dushanbe and Khudjand). The
surveillance included five vulnerable
group categories: IDUs, sex workers,
labour migrants, pregnant, and prisoners. The highest rates of HIV infection were registered among IDUs
and prisoners - 16% and 6 % respectively.1
Another concern is a dramatic increase in the number of SWs in the
country. According to the UNAIDS
survey in 2003 the approximate
number of SWs in the country was
8,000. The sentinel surveillance data
1
National AIDS centre, Tajikistan PPt presentation 2006
showed a 0.7%
HIV
infection
rate and a 20%
of syphilis2. Only half of the sex
workers reported
that they use
condoms.
Among
other
factors inductive
the spread of the
epidemic is a
huge
seasonal
labor migration
to Russia and
other CIS countries with high
National Forum devoted to World AIDS day
HIV/AIDS and
STIs infection rate. According to the edge, attitudes and behavior of the
latest estimates, about 450 to 600 general population and vulnerable
thousand labor migrants, predomi- groups. However, from the few studnantly young men (18-49 years old), ies available, there is still a low-level
leave the country annually for sea- of HIV/AIDS awareness among these
sonal work. There is a high incidence groups. For instance, there are many
of unprotected sexual contacts among misconceptions on the transmission
this group, and as a consequence, a routes of the HIV virus leading often
high risk for HIV infection. This to a strong stigmatization and distowards
PLWHA.
means that the spouses of labor mi- crimination
Moreover,
due
to
inadequate
knowlgrants are also at a high risk. The
2005 sentinel surveillance data edge, health care professionals often
showed a 2.2 % HIV infection rate do not feel at ease to provide care
and support to PLWHA.
among the labour migrants.
There is also alarming evidence that Evidently, there is a need to continue
HIV is spreading among the general strengthening a well-coordinated and
population. For example, 0.5% of the pro-active HIV/AIDS programme in
pregnant women living in Dushanbe Tajikistan. The grants of the GFATM
and Khudjand are found to be HIV are now playing a considerable role
positive. Compared with the sentinel in leading the prevention efforts
surveillance data in other Central among IDUs, SWs, young people,
Asian countries, Tajikistan has a street children, general population
higher HIV infection rate among and the health professionals.
pregnant women.
In general, there is still insufficient
reliable data available on the knowl2
Sentinel Surveillance report, 2005 Tajikistan
For more information please contact:
Ms. Zebo Jalilova ([email protected]) or Mr. Ulugbek Aminov ([email protected])
UNDP Tajikistan, GFATM Grants Implementation Unit, 28 Chehova Street, Dushanbe. Tel: +992 47 441-06-70
UNDP Tajikistan is a Principal Recipient
of the GFATM grants
In 2002, Tajikistan was awarded a three-year US$
2.4 million allocation from the Global Fund to Fight
AIDS, Tuberculosis and Malaria
(GFATM) directed at HIV/AIDS
prevention. In addition, in 2004,
Tajikistan received a second grant
for five-year USD 8.1 million allocation from the GFATM. The
grants support the national response to the HIV/AIDS epidemic
by providing funds for building a
system of blood safety control,
improving capacity for testing and
monitoring, providing treatment
and care for HIV+ people and expanding preventive
programmes among intravenous drug users, commercial sex workers, migrants,
street
children,
youth, prisoners and other
vulnerable groups.
By decision of the National
Coordination Committee of
Tajikistan on HIV/AIDS,
TB and malaria, the UNDP
Country Office was assigned as Principal Recipient for both grants.
Overview of the GFATM grants in Tajikistan:
HIV/AIDS Grants
Round 1 (completed)
PURPOSE: Support to the implementation of the Strategic Plan to Prevent HIV/AIDS Epidemics in Tajikistan
DURATION: 25 April 2003 - 25 April 2006
PROPOSAL AMOUNT: USD 2,425,245.00
APPROVED AMOUNT: USD 2,425,245.00
BENEFICIARIES: General population, injecting drug users, commercial sex workers, youth and other groups considered high risk because of unsafe behavior or inappropriate social environment.
OBJECTIVES:
• Reduction of risk behavior of vulnerable groups of population in terms of promotion of safe sexual and injecting practices.
• Building capacities of the national laboratory service for diagnostics, blood safety control and HIV surveillance.
• Building capacities to provide stronger leadership of the government on HIV/AIDS prevention, better cross-sectoral coordination, and continued
dialogue between the government and NGOs on central and local levels.
Main accomplishments
Increase in the coverage of IDUs
and SWs by harm reduction
programmes implemented on the
funds of the GFA TM grant in
Tajikistan
6000
5000
4000
3000
2000
1000
0
2002
dec 03
IDU
dec 04
dec 05
apr 06
SW
HIV/AIDS/STI prevention activities
among Injecting Drug Users and
Sex Workers
11 trust points for intravenous drug
users (IDUs) and 8 friendly cabinets for sex workers (SWs) and
one unique friendly cabinet for
men having sex with men (MSM)
have been established with the
grant funds. In total, 8,773 beneficiaries have been reached by the
activities of the harm reduction
program. This includes 5,359
IDU’s (representing 36% of the
estimated total number of IDUs in
the country) and 3,414 sex workers
(68% of the total).
The beneficiaries of the program
have been provided with sterile
syringes and needles, condoms,
disinfectants and information materials. Moreover, the programme
provided access to consultations
with various specialists, voluntary counseling and testing, and
STI treatment services. Syringes,
needles and condoms have been
provided by six organizations
implementing harm reduction activities among IDUs and SWs
under the auspices of the Open
Society Institute (OSI).
For more information please contact:
Ms. Zebo Jalilova ([email protected]) or Mr. Ulugbek Aminov ([email protected])
UNDP Tajikistan, GFATM Grants Implementation Unit, 28 Chehova Street, Dushanbe. Tel: +992 47 441-06-70
As a result of the conducted activities, the number of IDUs following safe injecting practices
has increased from 2 to 40%.
Likewise, the number of SWs
following safe sexual practices
has increased from 5 to 40%.
---------------------------------------Youth Education and Prevention
Awareness raising campaigns
aimed at improving knowledge
of street kids about HIV and STI
prevention has been carried out
throughout the country together
with six 6 local NGOs. More
than 6000 street children and outof-school youth were reached
under the both GFATM grants.
----------------------------------------
Access to STI comprehensive
case management
veillance for HIV and diagnosis
making
The access of vulnerable groups to
STI syndrome treatment and care
services has significantly improved.
Through the funds of the grant,
sufficient quantities of STI medicines was procured, and specialists
trained. More than 1,700 IDUs,
SWs and MSM have received
treatment during three years. In
addition, 483 youth living in districts with limited capacities for
STI management were provided
with required treatment.
Capacities for HIV diagnostics
and blood surveillance in the
country have been significantly
improved. 13 national laboratories were provided with required
equipment for HIV diagnostics.
Thereby, the country’s needs for
testing materials have been met
by 100% through the supply of
high quality ELISA and Western
Blot test systems, as well as rapid
tests for HIV diagnostics. More
than 177,000 HIV tests have
been performed with the procured tests during three years.
-------------------------------------Development of national capacities to improve blood safety sur-
For more information please contact:
Ms. Zebo Jalilova ([email protected]) or Mr. Ulugbek Aminov ([email protected])
UNDP Tajikistan, GFATM Grants Implementation Unit, 28 Chehova Street, Dushanbe. Tel: +992 47 441-06-70
Round 4 (ongoing)
PURPOSE: Reducing burden of HIV/AIDS in Tajikistan
TOTAL PROPOSAL AMOUNT: USD 8,128,972.00
PHASE 1 DURATION: 1 January 2005 - 31 December 2006
AMOUNT APPROVED FOR PHASE 1: USD 2,508,720.00
BENEFICIARIES: People living with HIV/AIDS, migrants, street children, prisoners, and traditional community based organizations and community leaders.
OBJECTIVES:
• Reduction of vulnerability and provision of access to HIV/AIDS and STI prevention for labor migrant and their family members, street children and
prisoners.
• Provision of access for the people living with HIV/AIDS to effective treatment, care and support.
• Capacity building for the National AIDS services on monitoring and evaluation of HIV/AIDS epidemics in the country.
Main accomplishments
Expansion of the prevention programme on raising awareness
among labour migrants and their
families about HIV/AIDS.
30 districts with high migration outflow rate were covered and about 791
people from the target group reached
with information and behavioural
change communication activities.
30 friendly cabinets in the country
are providing STI prevention and
treatment services to the labour migrants and their families. Overall,
more than 2,5 thousand labour migrants and their spouses received
required treatment.
-------------------------------------------Successful
implementation
of
awareness raising activities among
street children and unorganized
youth.
Overall, from the beginning of the
program under both GFATM grants,
400 volunteers were trained to pro-
vide peer education for street children. Approximately 12 thousand
street children and out-of-school
youth have been covered with IEC
materials and behavioural change
education and communication activities.
Acceleration of antiretroviral treatment of people living with
HIV/AIDS.
In Tajikistan, the ARVT programme
started in early 2006. As of today 67
patients started ARV, 4 died, 2 lost
follow up and 1 stopped to take the
drugs.
It is necessary integrate ARV clinics
in the PHC facilities as most patient
will be treated in out patient services.
Also, there is a need for reduction of
stigma and discrimination towards to
the PLWHA by the community, family and health workers.
-------------------------------------------Awareness raising activities and STI
treatment services implemented in
penitentiary institutions.
HIV/AIDS and STI prevention activities among prisoners are carried
out in 18 penitentiary institutions of
Tajikistan. More than 37 thousand
copies of IEC materials on
HIV/AIDS and STI prevention were
distributed among the prisoners from
the beginning of the programme. 2,1
thousand prisoners have received STI
syndrome treatment.
--------------------------------------------
Informational billboard
located in the prison
Improvement of capacities for HIV
counseling and testing services in
the country.
More than 131 thousand people received counseling and testing (VCT)
on HIV with the tests provided on the
funds of the GFATM grant from the
beginning of the programme. Capacities of VCT service providers were
improved on pre- and post-test counseling and testing, counseling for
HIV positive pregnant women and
care for their newborns through a
series of seminars.
UNDP Tajikistan will continue applying efforts to strengthen partnership within the framework of the
Global Fund grants, improve monitoring of activities of the sub-recipients and further develop coordination of activities to fight AIDS, Tuberculosis and Malaria in the Republic of Tajikistan.
For more information please contact:
Ms. Zebo Jalilova ([email protected]) or Mr. Ulugbek Aminov ([email protected])
UNDP Tajikistan, GFATM Grants Implementation Unit, 28 Chehova Street, Dushanbe. Tel: +992 47 441-06-70